Toxicology & Emergency Medicine research on Suspected Drink Spiking: A Summary

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The takeaway, from the group of 20+ years of studies:

1) Most suspected cases involve high blood alcohol levels and result in no other drug findings.

2) When drugs are found, they tend to be common illicit and prescribed drugs, such as marijuana, cocaine, benzodiazepines, and methamphetamine.

3) As for drugs unaccounted for by the patient, it turns out to be harder than scientists anticipated to separate voluntary from involuntary ingestion, particularly with GHB and benzodiazepines.  GHB is often substituted by dealers for other drugs, or combined in club drug doses with other drugs. Benzodiazepines are widely prescribed for anxiety and stress. It is often unclear whether the drugs are linked to the incidents and symptoms in question, as they may be from days beforehand.

4) Ketamine and Rohypnol are rarely found. GHB is found more often than these drugs, but not found that often, either. All three, associated in the press as “date rape drugs” are, in fact, used voluntarily the great majority of the time, and are not particularly prominent in positive drug tests related to suspected drugging or spiking.

5) The more recent the study is (roughly after 2005), the more likely it is to account for the potential exit of GHB from the system within as few as 12 hours. All other drugs implicated in drink spiking remain in the system for up to 48 hours or longer.

6) GHB and alcohol are not often found together. The State Library of New South Wales, Australia, notes that were GHB drink spiking more common than lab studies suggest, there would be more fatalities, as the combination of GHB and alcohol is quite dangerous.

7) The real mystery is how to interpret and estimate the set of unreported and unexamined cases.

8) NOTE: The term “drug-facilitated sexual assault” refers broadly to assault victimization that take place after voluntary or involuntary ingestion of drugs or alcohol. Some of these studies are related to sexual assault specifically and others are not.

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